Demystifying Scleral Lenses by Dr. Karen G. Carrasquillo

Online Optom Learning Series (OOLS) Sessions

Dr. Karen G. Carrasquillo, a contact lens expert and an optometry educator begins by stating that there is a significant global increase and benefit with the use of scleral lenses. This is evident as the number of scleral lenses has increased. She mentions a few key pointers to remember when interpreting these studies. She then focuses on certain areas with scleral lenses. They are described below:

  1. Effect of clearance or Vault on Hypoxia
    1. Lipid keratopathy clears over time due to multiple scleral lens fitting factors 
    2. Neurotropic keratopathy opacity clears over a span of 9 years 
    3. Cornea clears over time with use of well fit scleral lenses 
  2. Long-term outcomes with old grafts
    1. Penetrating keratoplasty with secondary keratoconus 
    2. Keratoconus with penetrating keratopathy 
  3. Effects of scleral lenses on intraocular pressure
    1. Keratopathy secondary to chronic exposure with glaucoma 
    2. Keratoconus, dry eye and glaucoma 

In conclusion, Dr.Carrasquillo, mentions to not overfocus on one particular scleral lens fitting parameter. She specifies that not all the scleral lens fits are the same. Moreover, long-term studies with larger sample are needed to derive better conclusions. Lastly, the session concludes with a question and answer session with the audience.

References

Papers

Povedano-Montero FJ, Álvarez-Peregrina C, Hidalgo Santa Cruz F, Villa-Collar C, Sánchez Valverde J. Bibliometric Study of Scientific Research on Scleral Lenses. Eye Contact Lens. 2018 Nov;44 Suppl 2:S285-S291.

https://pubmed.ncbi.nlm.nih.gov/29373387/

Hackshaw A. Small studies: strengths and limitations. Eur Respir J. 2008 Nov;32(5):1141-3.

https://pubmed.ncbi.nlm.nih.gov/18978131/

New England College of Optometry, Carrasquillo KG. What makes a scleral lens fit physiological? A case report. OCR 2018;5:1–5.

https://www.heraldopenaccess.us/openaccess/what-makes-a-scleral-lens-fit-physiological-a-case-report

Phillis K, Brocks D, Carrasquillo KG. Case Report: Use of Prosthetic Replacement of the Ocular Surface Ecosystem Treatment of Traumatic Lid Ptosis in a Pediatric Patient. Optom Vis Sci. 2020 Dec;97(12):1029-1033.

https://pubmed.ncbi.nlm.nih.gov/33259377/

Schornack M, Lin OC, Carrasquillo KG. Physiology of a Scleral Lens Fit; 2019

https://www.clspectrum.com/issues/2019/october-2019/physiology-of-a-scleral-lens-fit

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